MRI of the knee: value of short echo time fast spin-echo using high performance gradients versus conventional spin-echo imaging for the detection of meniscal tears

Objective. Fast spin-echo (FSE) sequences reduce imaging time compared with conventional spin-echo (CSE) sequences, but may result in blurring. Highperformance gradients permit shorter interecho spacing and use of the second echo as the effective TE (20 ms); both improvements reduce blurring. This randomized observer study compared a short TE, second-echo FSE sequence obtained using high-performance gradients and a CSE sequence with similar TR/TE for the detection of meniscal tears in the knee. Design and patients. One hundred consecutive MR examinations of the knee using FSE and CSE sequences at 1.5 T were evaluated. The FSE sequence used an effective TE of 20 ms (centered on the second echo at 2 times minimal interecho spacing) and an echo train length of 4. FSE and CSE parameters were otherwise similar. Four independent, masked readers reviewed randomized sagittal FSE and CSE sequences. Results. Cases were assessed for the presence or absence of meniscal tears and, if present, whether tears were medial or lateral and anterior or posterior. Sequence concordance was 93.5% (1496 of 1600 meniscal segments); the intermethod kappa value was 0.78. Sequence quality was graded from 1 to 5. Average quality of CSE images was slightly but statistically significantly preferred by three of the four readers. Conclusion. There was no statistically significant difference between CSE imaging and FSE imaging centered on the second echo (20 ms) using high-performance gradients for the detection of meniscal tears in the knee. There was a small preference for the quality of CSE images.